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HomeMy WebLinkAboutPermit Electrical 1997-10-10 '1 [. lIIIII-' , ------ Zoning-\y)cl y Oate\ [}- J () - <17 ~d~*-' ~ . 225 FIrlifhSmEfinature rJ ~ "'~<<, {:> ~LECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 ~~ # (\~ r./ a INSPECTION REQUEST: 726-3769 .B.~ ~t/f ~$:) <(City Job Number '7 j / /57 OFFICE: 726-3759 <<,'T"'.~ ~..... ~ 1Y ~LETE FEE SCHEDULE BELOII 1. LOCATION OF INSTALWION ~. ~ <::,~ ~<<,((:. ~'f- ~/'::?6 .-c;;,r<;,(~A;A~~{J _<>,'*' ~-0~ f0-1p. ~e~ ~esid7ntial-single.or (/ - ~v <?V ~<<,v 0 if)\1!ul tl-Famlly per d~elhng uni t. LEGAL DESCRIPTION "'~<::, ~O<('. ~v~ ~<<,<('. Service Included: \{:\ .,<c."" "'~ Items Cost Sum r ~'- r;;:;v JOB DESCj.IPTION va.s\ ,'8 IUu~ ..AouS' c;... ~~ uA-"')rCo v Permi ts are non-transferab,le .and expire if ~ork is not started ~ithin 180 days . of issuance or if ~ork is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY .B. Electrical Contractor~\"~\1~j~~ Address PD, &'l. 1~3.;l3 Ci ty go l~ V'n .Phone .fx:2.,-/1R/i-J./8'1Q Supervisor License Number 2:{ :?'? -;0,_ Expiration Date J()-I -qg Constr Contr. Number ()~o5q3 1000 sq.ft. or less ) $ 85.00 Each additional 500 sq. ft or portion / thereof $ 15.00 Each Manuf'd Home. or ModularDllelling Service or Feeder S 40.00 Services or Feeders , Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps 401 amps to, 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only $ 50.00 S 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation Expiration Date ;;'-/~-qq Signature of Supervising Electrician ~L~#c?2A6/ Ollners Name~' \1"Hol'Vu~ ~ Address 'RCI ::;, ~ciflc. Au)", LB.() rsnx LJSl '-' City YV11ll'1vuau:1-h Phone .t:)()?-,-R~'iS-OOCjIo 01lNER INSTALLATION The'installation is being made on property I Olin IIhich is not intended for sale, lease or rent. Ovners Signature: --------------------------------------- DATE: Ib -/0 - '7 7 RECEIPT 11: ;}7&4- '7 b"~"T,,,.,n tJv. K'w 200 amps'.OY less, 201 amps to 400 amps Over 401 to 600 amps ,Over 600 'amps or 1000, volts D. Branch Circui ts $ 40.00 S 55.00 S 80.00 see.~ uBu above " Ne~. Alteration or Extension Per Panel One Circu'i t Each Addi tional Circuit or ~ith Service or Feeder Permit $ 35.00 $ 2.00 no t included) Miscellaneous (Service/feeder -Each installation . Pump or i rriga t ion' Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee 'I'O'l'A1. S 40.00 $ 40.00 $ 20.00 $ 36.00 /42oal .'>-{'7d ,~ nO /c.?$'~OCL